Faustina Nwanekwu
Mental health is a major aspect of human health however for countries in sub-Saharan Africa it is the most neglected aspect of public health. Despite the overwhelming data by the World Health organization on mental health disorders, government at all level continues to live in denial.
For many, the lack of commensurable awareness, sensitization and effective legislation may be affecting discrimination and sensitization.
In 2021, 45-year-old, Mrs Luchy Azubuike, a resident of Rumukpokwu in port Harcourt lost her adopted child to iron deficiency. The once vibrant woman said she went into a melancholic state forcing her to lose every reason to live and continue with her daily activities. Luchy, a teacher before the sad incident suddenly stopped working and her social life and personal hygiene began to dwindle.
On a close contact with Luchy, she said “I lost the appetite for life and withdrew from a lot of physical activities. The period was traumatic for my husband because I couldn’t do anything for myself. For the understanding husband I have, my case would have been similar to the cases on the streets which are not being managed”
In the midst of this, Luchy was diagnosed with what is termed as “depressive stupor” by a shrink in a clinic in Port Harcourt, Elpida, a private psychiatric that caters for persons with mental disorders.
According to Dr. Metu Izuchukwu, resident psychiatrist of Elpida, said “Majority of depression, anxiety disorders related issue, substance use disorders are the most common mental health disorders in Nigeria in Nigeria hence the basis of stigmatization. But this is no way rule out other salient non drug abuse related causes of mental health”.
The Port Harcourt based Mental health Physician described mental disorder as a deviation from what is expected from an individual who is said to be mentally healthy, affecting the way the person functions socially or occupationally.
Dr Metu affirmed “depressive stupor is a mental health condition which immobilizes a patient’ and which usually occurs when the person ignores early symptoms of depression.
Mental health and stigmatization in Nigeria
Stigma, prejudice and discrimination against people with mental illness can be subtle or it can be obvious but no matter the volume, it can lead to harm and there should be strong institutions to support patients fight the discrimination.
Luchy said she was stigmatized: “Nobody wants to be identified except if a patient is lucky to have a friendly family. Mental health is seen as a big issue by many as patient may be to handle sometime”. In many situations many friends will run away so as not to be seen as a relative of a ‘mad person’. “Friends and some family members deserted me and I was left alone with my husband to bear the burden”, Luchy said
The basic assumption by the society is that many always believe mental health challenge is a product of drug abuse or a punishment from evil spirits. “A lot of people thought I was suffering from a mysterious illness even in church people feared to communicate and interact and those who dared shared a handshake would hurriedly go to wash their hands for fear of being infected” Luchy concluded
For Mrs Serena Kelechi, a resident of Port Harcourt, whose husband is diagnosed with “psychotic depression”. This disorder interfered with his social and interpersonal life and managing the condition is “tedious” especially during the episodic moments.
She expressed concern on the discrimination associated with caring for a partner with mental health challenges. “The stigma is so much, especially when the sufferer is responding negatively to anti-psychotic medication. In the case of my partner, he had tardive which lingered for a while and caused involuntary movement of his mouth and this made him suffer a lot of stigmatizations”. My husband condition also ” also made him withdraw from people and this affected his source of income, his self-esteem and interpersonal relationships with people,” Serena shared with concerns in her face.
Speaking further, the mother of five noted that the adverse effect of the drug “is worse than the mental disorder itself” appealing that the mental health laws should be strengthened to address stigmatization
A consultant neuropsychiatrist, Prof Donald Chukwujekwu says “Stigma and discrimination is a danger to mental health patients as it can make mental health management goes down south in some situations. It does discourage some from seeking or getting the help that she needs
Despite the overwhelming statistics by World Health Organization in 2018 highlighting dangers of mental health and that of 2019 which proclaimed Nigeria has Africa’s greatest number of cases of depression which is progressing, mental health awareness and sensitization in Nigeria has faced minimal success while the society continues to live in denial
The call for more increased sensitization and campaigns becomes imperative following the level of ignorance and the perception of the society on mental illness. Opinions amongst selected group of market women in a small market in Mini Orlu, Ada George in Port Harcourt, showed nine out of every ten had no idea of mental health and mental disorder and others saw mental disorders as “Mad people”
With the perception that people with mental disorders are lunatics it is evident that there is an information gap on the issue of mental disorders among and this becomes worrisome in a society with growing issues of mental disorders.
The misconception and attitude of society towards mental disorders is a pointer that awareness and the realities of the illness are unequal. Head of department, mental health, University of Port Harcourt, Prof Donald Chukwujekwu, has faulted the misinformation that infer that people with mental disorder are lunatics.
Can there be hope in the horizon?
Prof Chukwujekwu, said perception and cultural attitudes fuels the ignorance and theories of how people see mental disorders.
He said with the implementation of the 2021 mental health bill, people who stigmatize persons with mental health disorders may risk a jail term if convicted.
According to him, “This law protects the people with mental illness, from all forms of abuse, violence and torture. It empowers and advocates for their rights to access social services such as healthcare, education, employment and house. under this new act, anyone who violates the rights of people with mental illness if convicted, will be imprisoned for at least one year or fine of five hundred thousand naira”
Prof Chukwujekwu speaking on improved awareness and sensitization on mental illness, expressed worry over the attitude of government towards issues of mental health despite its severity. He stressed that lack of inefficient manpower is a critical constraint on neuropsychiatry.
He also revealed that beyond addressing the issues of stigmatization, government should prioritize and expand mental health services.
It must be acknowledged that persons with mental disorders may function relative optimally in the society but Prof Chukwujekwu noted that though some mental health disorder is a lifelong condition which needs adequate and continuous medical care.
Buttressing, Prof Chukwujekwu who is also the head of child and adolescent, mental health unit, department of neuropsychiatry, university of Port Harcourt said accessibility and deliverability of psychiatric care is relatively difficult in Nigeria, to him there is only “a ratio of about one qualified psychiatrist to about a million Nigerian” as a result of brain drain
While calling for the implementation and domestication of the 2021 mental health law, Prof Chukwujekwu, urged government to subsidize treatment of mental disorders beyond was is captured in the National health insurance scheme which gives limited access to patients. He stressed it will be viable in addressing issues of mental illness, discrimination and stigma.
To put an end to the discrimination and stigma, operationalizing the mental health law, 2021 which was signed by the outgone president becomes imperative as it addresses the major concerns plaguing mental health delivery, promotes and protects and addresses stigma and discrimination in home, schools, workplace communities and even mental health care system.
Pc: Google (used to prevent stigma)
